Clinical Co-Management as the Bridge Toward Bundled Care

Clinical Co-Management Agreement (CCMA) serves as the precursor to fully bundled care and can serve as the bridge from fee-for-service (FFS) to bundling. CCMAs are the beginning point and the catalyst for providers to lay the groundwork for making bundling feasible and financially attractive. The financial incentives to move from an FFS system to a bundled one already exist, albeit theoretically. The Affordable Care Act contains several initiatives regarding bundling, including a Medicare bundling pilot program called the Bundled Payments for Care Improvement Initiative (BPCI). Under BPCI, the CMS Innovation Center created four bundling models: Retrospective Acute Care Hospital Stay Only, Retrospective Acute Care Hospital Stay plus Post-Acute Care, Retrospective Post-Acute Care Only, and Acute Care Hospital Stay Only. In addition to the benefit of tying performance to quality of care, bundling also has the potential for reining in costs while promoting equal or higher quality of care.